Journal of Clinical Neurology最新文献

{"title":"Cerebrolysin and Risk of Hemorrhagic Transformation: A Pooled Analysis of Recent Studies.","authors":"Bassel Alrabadi, Yousef Alghzawi, Natalie Bandak","doi":"10.3988/jcn.2025.0547","DOIUrl":"10.3988/jcn.2025.0547","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"235-236"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Visual Evoked Potential Monitoring in Endoscopic Endonasal Surgery for Nonpituitary Adenoma Suprasellar Tumors.","authors":"Young Nam Kwon, Hwa Reung Lee, Myung Jae Lee, Young Ung Kim, Seung Woo Kim, Ha Young Shin, Sung-Min Kim, Ju Hyung Moon, Jong Hee Chang, Eui Hyun Kim","doi":"10.3988/jcn.2025.0207","DOIUrl":"10.3988/jcn.2025.0207","url":null,"abstract":"<p><strong>Background and purpose: </strong>Intraoperative visual evoked potential (VEP) monitoring has been studied mainly in pituitary adenoma, while its role in nonpituitary suprasellar tumors has remained unclear. This study evaluated the predictive usefulness of intraoperative VEP monitoring during endoscopic endonasal surgery (EES) and aimed to identify optimal alarm criteria for visual outcomes.</p><p><strong>Methods: </strong>We retrospectively analyzed a cohort of 87 patients who underwent EES with intraoperative VEP monitoring between April 2021 and September 2023. Visual outcomes were evaluated preoperatively and at short-term (≤3 months) and long-term (12 months) follow-ups, with visual deterioration at these time points defined as worsening of either visual acuity or the visual field. Reductions in the VEP amplitude were quantified using both the maximum intraoperative decrease and the final amplitude after recovery. Receiver operating characteristic (ROC) curve analyses were performed to identify the optimal alarm thresholds, and the sensitivity, specificity, positive predictive value, and negative predictive value were calculated for short-term and long-term visual deteriorations.</p><p><strong>Results: </strong>Short-term and long-term visual deteriorations were detected in 12 (9.2%) and 5 (3.8%) of the 130 analyzed eyes, respectively. ROC curve analyses identified ≥40% and ≥30% reductions in the N75-P100 amplitude as optimal alarm criteria for short-term and long-term visual deteriorations, respectively. A 30% reduction without intraoperative recovery demonstrated markedly higher sensitivity than the conventional 50% alarm threshold for short-term (58.3% vs. 33.3%) and long-term (80.0% vs. 20.0%) outcomes, while maintaining acceptable specificity (82.2% and 80.8%, respectively).</p><p><strong>Conclusions: </strong>A 30% reduction in amplitude represents a more-sensitive and clinically relevant alarm threshold than a 50% reduction for intraoperative VEP monitoring during EES for nonpituitary suprasellar tumors. Incorporating both the magnitude and recovery pattern of VEP amplitude changes may improve the accuracy of predictions of long-term visual deterioration. However, the potential for false positives warrants cautious interpretation, and further studies are needed to validate the impact of intraoperative VEP monitoring on visual outcomes.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"221-228"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White Matter Hyperintensities and Neuropsychiatric Symptoms in Neurodegenerative Diseases.","authors":"Shigeki Katakami, Hideki Kanemoto, Daiki Taomoto, Yuto Satake, Takashi Suehiro, Shunsuke Sato, Kenji Yoshiyama, Tetsuo Kashibayashi, Ryuichi Takahashi, Kenji Tagai, Shunichiro Shinagawa, Kazunari Ishii, Hiroaki Kazui, Manabu Ikeda","doi":"10.3988/jcn.2025.0408","DOIUrl":"10.3988/jcn.2025.0408","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neuropsychiatric symptoms (NPS) are frequent in dementia and mild cognitive impairment (MCI), yet their reported associations with white matter hyperintensities (WMHs) remain inconsistent. We examined item-level associations between WMHs and NPS across Alzheimer's disease dementia (ADD), dementia with Lewy bodies (DLB), and amnestic MCI (aMCI).</p><p><strong>Methods: </strong>This multicenter retrospective study involved 523 patients: 276 with ADD, 67 with DLB, and 180 with aMCI. Three-dimensional T1-weighted and T2-fluid-attenuated inversion recovery magnetic resonance images were processed with BAAD (Brain Anatomical Analysis using Diffeomorphic Deformation) software to quantify WMH volume (WMHV) and gray matter volume (GMV), normalized to total intracranial volume (TIV). NPS were assessed using the Neuropsychiatric Inventory. Multiple regression analyses were performed within each group, adjusting for GMV/TIV, age, sex, years of education, Clinical Dementia Rating-Sum of Boxes score, and institution.</p><p><strong>Results: </strong>In the aMCI group, higher WMHV/TIV was positively associated with depression, apathy, and disinhibition, and negatively with delusions. Subregional analyses revealed NPS-specific topographic patterns. No significant associations were detected in the ADD or DLB group. GMV/TIV was positively associated with delusions in the ADD group, but negatively associated with hallucinations in the DLB group.</p><p><strong>Conclusions: </strong>Associations between WMHs and NPS were evident in the aMCI group but absent in the ADD and DLB groups, suggesting a stage-dependent effect. WMHs may contribute to NPS primarily in prodromal stages, whereas their influence may be overshadowed by neurodegenerative pathology in dementia. Clarifying the mechanisms underlying WMHs is critical for evaluating their potential as intervention targets.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"183-192"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Onset, High Comorbidity Burden, and Regional Disparities of CADASIL: A Nationwide Cohort Study in South Korea.","authors":"Ju-Yeun Lee, Minwoo Lee, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Young Eun Kim, Hyeo-Il Ma, Yun Jin Kim, Jong Ho Park, Young Hee Jung","doi":"10.3988/jcn.2025.0373","DOIUrl":"10.3988/jcn.2025.0373","url":null,"abstract":"<p><strong>Background and purpose: </strong>To compare the epidemiological and clinical features of the rare patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) with age- and sex-matched controls in a nationwide cohort from South Korea.</p><p><strong>Methods: </strong>This observational cohort study analyzed newly diagnosed CADASIL patients aged at least 20 years and matched controls using data from the National Health Information Database for 2004-2022. The cumulative incidence of CADASIL was assessed by age and sex, and compared between regions. Neurologic and systemic diseases were compared between the CADASIL and control groups.</p><p><strong>Results: </strong>The study analyzed 816 CADASIL patients and 816 age- and sex-matched controls aged 56.8±15.2 years (mean±standard deviation), among whom 48.3% were male. The cumulative incidence of CADASIL was 1.86 per 100,000 people (95% confidence interval [CI]=1.85-1.87 per 100,000), and peaked at 60-69 years of age. In terms of regional distribution, the incidence was highest for Jeju, at 39.67 per 100,000 (95% CI 37.84-41.49 per 100,000). Neurologic diseases were more frequent in CADASIL patients, including Alzheimer's disease (33.1% vs. 20.0%), vascular dementia (84.9% vs. 5.0%), epilepsy (34.6% vs. 15.9%), stroke (70.7% vs. 27.6%), parkinsonism (18.9% vs. 11.0%), and depression (60.8% vs. 44.9%). Systemic diseases such as diabetes mellitus (78.9% vs. 68.9%) were also more common in CADASIL patients, while cancer (27.9% vs. 38.7%) and myocardial infarction (10.0% vs. 13.6%) were less common than in controls. The onset ages of all diseases were lower in CADASIL patients.</p><p><strong>Conclusions: </strong>This study has provided a precise nationwide estimate of the CADASIL incidence and its regional distribution in South Korea. CADASIL patients showed higher incidence rates and earlier onsets of diverse clinical manifestations.</p>","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"173-182"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Biomarkers for Moyamoya Disease Beyond Angiography.","authors":"Hyuk Sung Kwon, Seong-Ho Koh","doi":"10.3988/jcn.2026.0036","DOIUrl":"10.3988/jcn.2026.0036","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"149-150"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversible Cerebral Vasoconstriction Syndrome With Ischemic Stroke Underlying Ring Finger Protein 213 Vasculopathy.","authors":"Hong Keun Yoo, Jeong Soo Lee, Soo Jeong, Young Seo Kim","doi":"10.3988/jcn.2025.0559","DOIUrl":"10.3988/jcn.2025.0559","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"232-234"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Vestibulocerebellar Control of Posterior Canal Afferents: Implications From Central Positional Vertigo and Nystagmus.","authors":"Hyunji Kim, Eun-Hyeok Choi, Jeong-Yoon Choi, Ji-Soo Kim","doi":"10.3988/jcn.2025.0596","DOIUrl":"10.3988/jcn.2025.0596","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"246-248"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generalized Dystonia in Fahr's Syndrome Secondary to Idiopathic Hypoparathyroidism: Improvement After Metabolic Correction.","authors":"Jun Seok Lee, Sooyeoun You","doi":"10.3988/jcn.2025.0620","DOIUrl":"10.3988/jcn.2025.0620","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"240-242"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Recovery From Radiation-Induced Oculomotor Nerve Palsy.","authors":"Hyunji Kim, Kihwan Hwang, Jeong-Yoon Choi, Ji-Soo Kim","doi":"10.3988/jcn.2025.0638","DOIUrl":"10.3988/jcn.2025.0638","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 2","pages":"243-245"},"PeriodicalIF":3.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: \"The 30-Day Risk of Sudden Death in Patients With Epilepsy: A 10-Year Population-Based Cohort Study\".","authors":"Josef Finsterer","doi":"10.3988/jcn.2025.0490","DOIUrl":"10.3988/jcn.2025.0490","url":null,"abstract":"","PeriodicalId":15432,"journal":{"name":"Journal of Clinical Neurology","volume":"22 1","pages":"139-140"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}